**Abstract**

Diabetes Mellitus type 2 is a metabolic ailment. It is a condition when insulin is produced by our body but, it is not used properly by us. The number of diabetic patients is increasing in the whole world. The problem of obesity is also very closely related to it, which itself is expanding. The individuals diagnosed with type 2 Diabetes Mellitus have high chance of microvascular problems (like nephropathy, retinopathy and neuropathy). They are also at the verge of facing macrovascular ailments (like cardiovascular comorbidities). This indicates that many antidiabetic agents should be administered in combination, to maintain normal sugar level in blood. The management for the patients suffering from diabetes should be effective and harmless for them. It should also improve the general well-being of the patients. So many remedies have been developed for the management of diabetes. Several of them are being developed. We should enhance insulin sensitivity to let our body use insulin effectively. We also must stop the increasing pancreatic β-cell failure which is a specific characteristic of Diabetes Mellitus type 2. The microvascular complications must also be avoided or revoked. Our direst need is to develop agents which may help us in achieving goals mentioned earlier. Many micronutrients are involved in combating the Diabetes Mellitus and complication associated to the malady. These micronutrients are vitamins. Our main focus in this chapter are Vitamins B9 (Folate) and B12 (Cobalamin). Many researches have shown that the said parameters were decreased in patients suffering from Diabetes Mellitus. The level of these two vitamins should be maintained to the normal level and not toward the border line. The maintained level of these vitamins will help in controlling the main problems in patients suffering from Diabetes Mellitus like neuropathy, anemia and many others. By taking these vitamins along with other preventive measures, Diabetes Mellitus can be controlled and can be less dangerous.

**Keywords:** diabetes mellitus, cobalamin, folic acid, microvascular complications, micronutrients

### **1. Introduction**

The permanent harm, dysfunction, and failure of multiple human body parts, like eyes, kidneys, heart, nerves and blood vessels could be caused by persistent hyperglycemia [1].

#### **1.1 Preventing the development of diabetes mellitus**

The risk of the diabetes raises seven times in older age (55+) than it is in younger age (20 to 34 years old). So, it is really important to gear up to control diabetes in

midlife. Specially minimizing the spread of type 2 Diabetes Mellitus is crucial for individuals and even the societies. The importance of eradication of *type 2 Diabetes Mellitus* is even because of its harmful side effects.

Healthy lifestyle and body-weight control in midlife plays a crucial role in avoiding or postponing manifestation of type 2 Diabetes Mellitus since lifestyle interventions seem more durable concerning their protective potential in this part of life. The different pharmaceutical approaches to eradicate type 2 Diabetes Mellitus are not effective after they root out the disease for the first time. Also, such approaches have so many side effects on the patients going through such techniques. Therefore, for the time being, no drug is licensed for diabetes prevention.

Nonetheless, novel medicaments' attempts for diabetes prevention and supporting healthy aging are under scientific investigation. The diabetes can result in severe hypoglycemia, premature cardiovascular complications, other severe problems and even death. So, every possible step should be taken in order to eradicate this. The lifestyle of the patient should be changed to fight diabetes. All possible pharmaceutical techniques should also be applied to control the ailment. Diabetes prevention has a vital influence in the making of health policy [2].

#### **1.2 Pathophysiology of diabetes**

Numerous pathogenic processes are responsible of the growth of diabetes. These range from autoimmune demolition of the pancreatic β-cells with subsequent insulin shortage to anomalies that result in confrontation to insulin action. Lacking insulin action results from insufficient insulin emission and/or reduced tissue responses to insulin at one or more points in the complex paths of hormone action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues. Weakening of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is mostly uncertain which anomaly, if either alone, is the main reason of the glucose excess in blood [1].

When we take the meal, the glucose levels in blood rise that activates insulin secretion. This results in a rise in biotransformation, transport and storage of insulin in fat tissues and muscles. During fasting, liver provides the glucose in blood that is used by the brain, without any dependence on insulin. Besides storing glucose, insulin also hinders the secretion of glucagon and drops the quantity of serum fatty acids resulting in a downfall in production of glucose in liver [3]. Inadequate insulin or confrontation to insulin in the body results in lessened uptake of glucose by tissues that has intracellular hypoglycemia and extracellular hyperglycemia as its outcome. The glucogenesis is caused by intracellular hypoglycemia and gluconeogenesis that results in breakdown of fats (resulting in diabetic ketoacidosis) and reduces synthesis of gamma globulins and protein (resulting in polyphagia, cachexia and reduced wound healing), while osmotic dieresis and hyperglycemic coma are caused by the extracellular hyperglycemia [4].

#### **1.3 Pathogenesis about type 1 diabetes mellitus**

A deficiency of insulin secretion occurs in Insulin dependent Diabetes Mellitus (IDDM). It is because of the autoimmune demolition of pancreatic beta cells that results in metabolic disorders associated with Insulin Dependent Diabetes Mellitus [4]. The last stage of β-cell demolition shows the beginning of clinical ailment resulting in type 1 diabetes mellitus. There the infiltrating lymphocytes, monocytes and a blend of pseudo atrophic islets form along with a few cells emitting glycogen, somatostatin and polypeptide from pancreas. This results in an immunogenic

**373**

the eating routine [12].

**2.1 Vitamins and diabetes mellitus type 2**

*Therapeutic Effect of Folate and Cobalamin in Diabetics DOI: http://dx.doi.org/10.5772/intechopen.96447*

**1.4 Pathogenesis about type 2 diabetes mellitus**

tissue insulin reluctance and beta cell problems [8].

emission by the beta cells of pancreas [9].

**2. Therapy of diabetes mellitus**

process whose outcome is the ailment [5–7]. Genetic makeup, autoimmunity and

Many healthy operations are impaired in Non-Insulin dependent diabetes mellitus (NIDDM). This lessens the adjustment of tissue acceptance to insulin which results in reduced insulin influence via insulin confrontation and reduced insulin

Several genetic imperfections, and some environmental factors like overweight-

As indicated by ongoing appraisals, the human populace overall seems, by all accounts, to be amidst a pestilence of diabetes. Notwithstanding the incredible steps that have been made in the comprehension and the executives of diabetes, the infection and sickness related difficulties are expanding continuously. Along with this, ongoing improvements in comprehension of the pathophysiology of the ailment procedure has unlocked a few new roads to distinguish and create novel treatments to battle the epidemic of diabetes [10]. The cure of diabetes with artificial medications is expensive and odds of reactions are so many. Phytomedicine has been utilized since old occasions in different regions around the globe where access to up-to-date drugs is restricted. Therapeutic plants and phytochemicals assume a significant job in the administration of diabetes mellitus particularly in underdeveloped nations where assets are small. Utmost pervasive amongst phytochemical bunches are the glycosides, alkaloids, polysaccharides and phenolics, for example, terpenoids, steroids and flavonoid. Regardless of impressive advancement in the improvement of artificial medications, the disclosure of phytomedicine as an elective treatment is increasing [11]. Simultaneously, phytochemicals recognized from customary medical plants are exhibiting an energizing open door for the improvement of new kinds of therapeutics. This has quickened the worldwide exertion to saddle and gather those restorative plants that bear significant number of potential phytochemicals appearing advantageous impacts in battling diabetes and diabetesrelated entanglements. In this manner, as the malady is advancing continuously, there is a critical need of recognizing native resources occurring in nature so as to get them, and concentrate in detail, their potential on various recently distinguished focuses so as to create them as new treatments [10]. The improvement of type 2 diabetes might be decreased by the admission of cancer prevention agents in

Nutrients are the natural mixes needed by our body which are termed as mandatory ingredients required in definite quantities. They cannot be made in adequate quantity by the human body, and thus, should be gotten from the eating routine. Thirteen distinct kinds of vitamins are found that are ordered by their organic and substance action; every one of them keeps a particular job in human body [13]. Vitamins are termed as either fat-dissolvable or water-solvent. There are thirteen vitamins found in nature. Nine of them could dissolve in water (8 B Vitamins and Vitamin C) whereas, four of them could dissolve in fat (A, D, E, and K). The

ness are important in this type of diabetes. They are accountable for peripheral

environmental factors are accountable for islets cell demolition [8].

*Type 2 Diabetes - From Pathophysiology to Cyber Systems*

*Mellitus* is even because of its harmful side effects.

for the time being, no drug is licensed for diabetes prevention.

has a vital influence in the making of health policy [2].

coma are caused by the extracellular hyperglycemia [4].

**1.3 Pathogenesis about type 1 diabetes mellitus**

**1.2 Pathophysiology of diabetes**

midlife. Specially minimizing the spread of type 2 Diabetes Mellitus is crucial for individuals and even the societies. The importance of eradication of *type 2 Diabetes* 

Healthy lifestyle and body-weight control in midlife plays a crucial role in avoiding or postponing manifestation of type 2 Diabetes Mellitus since lifestyle interventions seem more durable concerning their protective potential in this part of life. The different pharmaceutical approaches to eradicate type 2 Diabetes Mellitus are not effective after they root out the disease for the first time. Also, such approaches have so many side effects on the patients going through such techniques. Therefore,

Nonetheless, novel medicaments' attempts for diabetes prevention and supporting healthy aging are under scientific investigation. The diabetes can result in severe hypoglycemia, premature cardiovascular complications, other severe problems and even death. So, every possible step should be taken in order to eradicate this. The lifestyle of the patient should be changed to fight diabetes. All possible pharmaceutical techniques should also be applied to control the ailment. Diabetes prevention

Numerous pathogenic processes are responsible of the growth of diabetes. These range from autoimmune demolition of the pancreatic β-cells with subsequent insulin shortage to anomalies that result in confrontation to insulin action. Lacking insulin action results from insufficient insulin emission and/or reduced tissue responses to insulin at one or more points in the complex paths of hormone action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues. Weakening of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is mostly uncertain which anomaly, if either alone, is the main reason of the glucose excess in

When we take the meal, the glucose levels in blood rise that activates insulin secretion. This results in a rise in biotransformation, transport and storage of insulin in fat tissues and muscles. During fasting, liver provides the glucose in blood that is used by the brain, without any dependence on insulin. Besides storing glucose, insulin also hinders the secretion of glucagon and drops the quantity of serum fatty acids resulting in a downfall in production of glucose in liver [3]. Inadequate insulin or confrontation to insulin in the body results in lessened uptake of glucose by tissues that has intracellular hypoglycemia and extracellular hyperglycemia as its outcome. The glucogenesis is caused by intracellular hypoglycemia and gluconeogenesis that results in breakdown of fats (resulting in diabetic ketoacidosis) and reduces synthesis of gamma globulins and protein (resulting in polyphagia, cachexia and reduced wound healing), while osmotic dieresis and hyperglycemic

A deficiency of insulin secretion occurs in Insulin dependent Diabetes Mellitus (IDDM). It is because of the autoimmune demolition of pancreatic beta cells that results in metabolic disorders associated with Insulin Dependent Diabetes Mellitus [4]. The last stage of β-cell demolition shows the beginning of clinical ailment resulting in type 1 diabetes mellitus. There the infiltrating lymphocytes, monocytes and a blend of pseudo atrophic islets form along with a few cells emitting glycogen, somatostatin and polypeptide from pancreas. This results in an immunogenic

**372**

blood [1].

process whose outcome is the ailment [5–7]. Genetic makeup, autoimmunity and environmental factors are accountable for islets cell demolition [8].
